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Agnieszka "Aga" Jones
Aga Travel LLC
Returning Client - New Inquiry
<html> <body> <form-template> <fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field> <field type="header" subtype="h1" label="Welcome Back!"/> <field type="paragraph" subtype="p" label="It's great to hear from you and I look forward to working together again. I appreciate your business very much."/> <field type="checkbox-group" label="Would you like to schedule a phone consultation or would you like me to get started as soon as I receive the form?&nbsp;" name="would-you-like-to-schedule-a-phone-consultation-or-would-you-like-me-to-get-started-as-soon-as-i-receive-the-form-"> <option label="Phone consultation." value="phone-consultation">Phone consultation.</option> <option label="Get started!" value="get-started">Get started!</option> </field> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Questions for your trip"/> <field type="text" label="Is the purpose of this trip to celebrate an occasion?&nbsp;" name="is-the-purpose-of-this-trip-to-celebrate-an-occasion-" subtype="text" className="form-control"/> <field type="textarea" label="Tell me a little bit about what you are picturing for this vacation:" description="Destination(s) you are considering type of experience etc. Any details you can share will be helpful." name="tell-me-a-little-bit-about-what-you-are-picturing-for-this-vacation" className="form-control"/> <field type="checkbox-group" label="The purpose of this vacation is:&nbsp;" name="the-purpose-of-this-vacation-is-" other="true"> <option label="Romance" value="romance">Romance</option> <option label="Making Memories w/Family" value="making-memories-wfamily">Making Memories w/Family</option> <option label="Just For Fun!" value="just-for-fun">Just For Fun!</option> <option label="Relax & Recharge (Spa?)" value="relax-recharge-spa">Relax & Recharge (Spa?)</option> <option label="Celebrating a Special Occasion" value="celebrating-a-special-occasion">Celebrating a Special Occasion</option> </field> <field type="textarea" label="&nbsp;Anything you absolutely must do or see in the destination?" name="-anything-you-absolutely-must-do-or-see-in-the-destination" className="form-control"/> <field type="text" label="Accommodation Must-Haves" description="Inclusions location etc." name="accommodation-musthaves" subtype="text" className="form-control"/> <field type="text" label="Accommodation Nice-to-Haves" description="Inclusions location etc." name="accommodation-nicetohaves" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are any of these important?&nbsp;" name="are-any-of-these-important-" other="true"> <option label="Wheelchair Accessible" value="wheelchair-accessible">Wheelchair Accessible</option> <option label="Casino (not widely available)" value="casino-not-widely-available">Casino (not widely available)</option> <option label="Spa" value="spa">Spa</option> <option label="Babysitting" value="babysitting">Babysitting</option> <option label="Kids Club" value="kids-club">Kids Club</option> <option label="Parking" value="parking">Parking</option> </field> <field type="text" label="If you need air included, which airport will you depart from?" description="You can include more than one option" name="if-you-need-air-included-which-airport-will-you-depart-from" subtype="text" className="form-control"/> <field type="text" label="Preferred airline(s) and class of service, if any?" name="preferred-airlines-and-class-of-service-if-any" subtype="text" className="form-control"/> <field type="date" required="true" label="Earliest you can depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="earliest-you-can-depart" className="form-control"/> <field type="date" label="Latest you can return?&nbsp;" description="This just gives me a general idea of when you like to go; it can be changed later." name="latest-you-can-return-" className="form-control"/> <field type="text" label="How many nights would you like the trip to be (can be a range)?" name="how-many-nights-would-you-like-the-trip-to-be-can-be-a-range" subtype="text" className="form-control"/> <field type="text" required="true" label="What is the price range you are comfortable with? Please specify if it is per person or total." name="what-is-the-price-range-you-are-comfortable-with-please-specify-if-it-is-per-person-or-total" subtype="text" className="form-control"/> <field type="textarea" label="Any additional notes about the price range:" name="any-additional-notes-about-the-price-range" className="form-control"/> <field type="textarea" required="true" label="Who is coming on this trip? (Number of travelers and their ages)? If multiple rooms, please provide a breakdown of who goes in each room." name="who-is-coming-on-this-trip-number-of-travelers-and-their-ages-if-multiple-rooms-please-provide-a-breakdown-of-who-goes-in-each-room" className="form-control"/> <field type="checkbox-group" label="Which of these are the top 3 priorities?" inline="true" name="which-of-these-are-the-top-3-priorities" other="true"> <option label="Best experience for the money" value="best-experience-for-the-money">Best experience for the money</option> <option label="Lowest price" value="lowest-price">Lowest price</option> <option label="Authentic, immersive experiences" value="authentic-immersive-experiences">Authentic, immersive experiences</option> <option label="Just the highlights/main attractions" value="just-the-highlightsmain-attractions">Just the highlights/main attractions</option> <option label="Best accommodations" value="best-accommodations">Best accommodations</option> <option label="Basic accommodations: clean, safe, well-located" value="basic-accommodations-clean-safe-welllocated">Basic accommodations: clean, safe, well-located</option> <option label="Small, cozy hotel (more boutique)" value="small-cozy-hotel-more-boutique">Small, cozy hotel (more boutique)</option> <option label="Large property with on-site dining & amenities" value="large-property-with-onsite-dining-amenities">Large property with on-site dining & amenities</option> <option label="Guided tours " value="guided-tours-">Guided tours </option> <option label="Just the tickets/ no guide" value="just-the-tickets-no-guide">Just the tickets/ no guide</option> <option label="Private tours" value="private-tours">Private tours</option> <option label="Easiest flight schedule" value="easiest-flight-schedule">Easiest flight schedule</option> </field> <field type="radio-group" required="true" label="Is everyone in your party fully vaccinated? We only ask so that we can advise you properly. All information is private." name="is-everyone-in-your-party-fully-vaccinated-we-only-ask-so-that-we-can-advise-you-properly-all-information-is-private"> <option label="We are fully vaccinated with either Pfizer/BioNTech, Moderna, or J&J and it has been two weeks since our last shot" value="we-are-fully-vaccinated-with-either-pfizerbiontech-moderna-or-jj-and-it-has-been-two-weeks-since-our-last-shot">We are fully vaccinated with either Pfizer/BioNTech, Moderna, or J&J and it has been two weeks since our last shot</option> <option label="We have had our first shot of Pfizer/BioNTech or Moderna" value="we-have-had-our-first-shot-of-pfizerbiontech-or-moderna">We have had our first shot of Pfizer/BioNTech or Moderna</option> <option label="We are not vaccinated." value="we-are-not-vaccinated">We are not vaccinated.</option> </field> <field type="textarea" label="What else would you like me to know? Do you have any medical or dietary needs/preferences ? Does anyone in your party have mobility issues I should be aware of?" name="what-else-would-you-like-me-to-know-do-you-have-any-medical-or-dietary-needspreferences-does-anyone-in-your-party-have-mobility-issues-i-should-be-aware-of" className="form-control"/> <field type="radio-group" required="true" label="I have requested that Aga Travel make one or more travel bookings on my behalf. As the worldwide COVID-19 coronavirus pandemic remains ongoing at this time, I acknowledge that for this reason, and other reasons not reasonably foreseeable at this time, these travel plans may be interrupted or cancelled by the supplier that is providing them, a government entity or other third party over which Agency has no control. I further acknowledge that the supplier’s own cancellation, rebooking and refund policies, subject to any applicable law that is now or may later be in effect, will govern my rights and remedies, including my right to receive a refund, in such an event. Moreover, I understand that should I elect to purchase travel insurance, the terms of the policy will dictate whether, and to what extent, coverage for any financial loss may exist under the circumstances. By signing below, I hereby agree to hold Agency harmless and release it from any and all liability for any damages, including but not limited to monetary losses, I may incur as a result of such interruption or cancellation of these travel plans.&nbsp;" name="i-have-requested-that-aga-travel-make-one-or-more-travel-bookings-on-my-behalf-as-the-worldwide-covid19-coronavirus-pandemic-remains-ongoing-at-this-time-i-acknowledge-that-for-this-reason-and-other-reasons-not-reasonably-foreseeable-at-this-time-these-travel-plans-may-be-interrupted-or-cancelled-by-the-supplier-that-is-providing-them-a-government-entity-or-other-third-party-over-which-agency-has-no-control-i-further-acknowledge-that-the-suppliers-own-cancellation-rebooking-and-refund-policies-subject-to-any-applicable-law-that-is-now-or-may-later-be-in-effect-will-govern-my-rights-and-remedies-including-my-right-to-receive-a-refund-in-such-an-event-moreover-i-understand-that-should-i-elect-to-purchase-travel-insurance-the-terms-of-the-policy-will-dictate-whether-and-to-what-extent-coverage-for-any-financial-loss-may-exist-under-the-circumstances-by-signing-below-i-hereby-agree-to-hold-agency-harmless-and-release-it-from-any-and-all-liability-for-any-damages-including-but-not-limited-to-monetary-losses-i-may-incur-as-a-result-of-such-interruption-or-cancellation-of-these-travel-plans-"> <option label="I agree" value="i-agree">I agree</option> <option label="I do not agree" value="i-do-not-agree">I do not agree</option> </field> <field type="header" subtype="h1" label="Thank you again and I'll be in touch shortly!"/> </fields> </form-template> </body> </html>
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